ABSITE Review - Cardiac

Question 1

Which type of shunt from congenital heart disease cause cyanosis? What maneuvers help?

Answer 1

R to L shunts

Squats - increase SVRI and decreases the shunt

Question 2

What is Eisenmenger’s syndrome?

Answer 2

Shift from L –> R shunt to R –> L

Question 3

What is the end result of L –> R shunt?

Answer 3

CHF

Question 4

What is the first sign of CHF in children?

Answer 4

Hepatomegaly

Question 5

What are the congenital conditions that cause L –> R shunt?

Answer 5

VSD, ASD, PDA

Question 6

What are the congenital conditions that cause R –> L shunt?

Answer 6

Tetralogy of Fallot, Transposition of the great vessels, truncus arteriosus

Question 7

What is the ductus arteriosus?

Answer 7

Connection between descending aorta and left pulmonary artery; blood shunted away from lungs in utero.

Question 8

What is the ductus venosum?

Answer 8

Connection between portal vein and IVC; blood shunted away from liver.

Question 9

How many umbilical arteries and veins are present in fetal circulation?

Answer 9

2 umbilical arteries and 1 umbilical vein

Question 10

What is the MC congenital heart defect?

Answer 10

VSD

Question 11

What is the treatment for VSD?

Answer 11

Most close spontaneously by age 6 months
MC reason for repair - CHF resulting in FTT
PVR > 4-6 woods units also indication for repair
PVR > 10-12 contraindication for repair –> use vasodilators

Question 12

What is the MC type of ASD?

Answer 12

Ostium secundum

Question 13

What is the Tetralogy of Fallot?

Answer 13

VSD, pulmonic stenosis, overriding aorta, RVH

Question 14

What is the surgical treatment for Tetralogy of Fallot?

Answer 14

Blalock-Taussig shunt for palliation to delay repair

RV outflow tract obstruction division, patch enlargement of outflow tract and VSD repair

Question 15

What can be used to close a PDA?

Answer 15

Indomethacin

Question 16

What can be used to keep open a PDA?

Answer 16

PGE1

Question 17

Where is the MC location for coarctation of the aorta?

Answer 17

Usually occurs just distal to the L subclavian artery

Question 18

What syndrome is associated with CoA?

Answer 18

Turner’s Syndrome

Question 19

What is a CXR finding seen in CoA?

Answer 19

Rib notching from the IMA and intercostal collaterals

Question 20

What is the treatment for hypoplastic left heart?

Answer 20

Norwood procedure

Question 21

What is the MC heart dominant circulation?

Answer 21

Right dominant - MC - posterior descending artery comes off the RCA

Question 22

What are some complications of MI?

Answer 22

VSD (pansystolic murmur), papillary muscle rupture, and free wall rupture. Most likely to occur at 3-7 days post-MI.

Question 23

What is the best conduit for CABG?

Answer 23

Internal mammary artery - >90% 10-year graft patency rate

Question 24

What is the MC valve lesion?

Answer 24

Aortic stenosis

Question 25

What is the MCC of valve dysfunction?

Answer 25

Rheumatic heart disease - Mitral most commonly involved valve

Question 26

What are the indications to operate on a stenotic valve?

Answer 26

When symptomatic or valve area < 1cm2

Question 27

What is the MC site for prosthetic valve infection?

Answer 27

Aortic valve

Question 28

What is the MC site for native valve infection?

Answer 28

Mitral valve

Question 29

What is the MC organism resposible of endocarditis?

Answer 29

S. Aureus

Question 30

What are the indication for surgery in endocarditis?

Answer 30

Failure of antimicrobial therapy, valve failure, perivalvular abscesses, pericarditis

Question 31

Which patients need periprocedural endocarditis prophylaxis?

Answer 31

Prosthetic valves, rheumatic heart disease, congenital cardiac malformations, MVP with MR, previous hx of bacterial endocarditis

Question 32

What is the MC benign tumor of the heart?

Answer 32

Myxoma - 75% in LA

Question 33

What is the MC malignant tumor of the heart?

Answer 33

Angiosarcoma

Question 34

What is the MC metastatic tumor of the heart?

Answer 34

Lung CA

Question 35

What tissue in the body has the lowest oxygen tension?

Answer 35

Coronary veins due to high oxygen extraction by myocardium

Question 36

What is the postpericardiotomy syndrome? What is the treatment?

Answer 36

Pericardial friction rub, fever, chest pain, SOB | Tx - NSAIDs, steroids

Question 37

What is the first sign of cardiac tamponade in ECHO?

Answer 37

decrease right atrial diastolic filling